Will the survivor ever go back to school or work, and what kinds of resources are available to help in this area?
This is a question that is often asked during the topsy-turvy time immediately following spinal cord injury. After all, both work and school signify a return to normalcy, and that’s exactly what every survivor hopes to return to at some point.
While many well-intentioned people may tell you to slow down and take things on step at a time, we think that this is an excellent question. Why? Well, thinking about the future means that the survivor has, to some degree, accepted what has happened to him or her, but is willing to do what it takes to get back to a regular sort of life. The more the survivor yearns for work and school, the harder the survivor will work to see those specific goals met.
Back to School
When it comes to going back to school, there is no reason why the survivor shouldn’t do so once he or she is rehabilitated. While re-entering school can be stressful, the key to successfully going back to school is to have plenty of support and ensure that the needs of the survivor are identified ahead of time and met. When returning to school is a goal, the survivor should seek the help of an occupational therapist prior, as well as after, leaving rehabilitation. Together, patient and therapist can design a back-to-school program. This plan should include any potential modifications that need to be made to the environment, as well as how to handle issues such as bladder and bowel care, respiratory care, and other medical issues as they arise during the school day. Support staff that is needed should be briefed prior to the student going back to school, and teachers and other students should receive sensitivity training.
Both the survivor and his or her loved ones should realize that going back to school won’t always be smooth sailing. It will be rocky both physically and emotionally. The survivor may find the constant reminders of “how things used to be” saddening. He or she may be frustrated by the things classmates can do, that he or she no longer can. Friendships and relationships may change. As tempting as it may be at times to throw in the towel, continuing to attend school will allow the survivor to focus on his or her future, will help the adjustment process even though it may not often seem that way, and will help the survivor gain the critical skills necessary to live as independent a life as possible.
Back to Work
It used to be that if you re-entered the work force you lost your Social Security benefits. No longer. Today there are two programs designed to help SCI survivors re-enter the workforce without fear of losing their benefits.
Before we get into those, let’s get into the benefits of re-entering the workforce. Life changes so much after a spinal cord injury, that going back to work can provide a semblance of normalcy needed by the survivor. Work allows the survivor to feel useful, engage his or her brain, apply his or her talents and experience, and make friends and social connections. No wonder why it’s one of the main goals of all SCI survivors following rehabilitation!
However, a re-entry that isn’t thoughtful can have negative consequences. To that end, we suggest the survivor spend some time being assessed and counseled by a vocational therapist. The vocational therapist will asses the skills, interests, and capabilities of the person, and will help him or her come up with viable work options. The therapist can also ensure that the work environment is modified in a way that gives the survivor the best chance of success. Survivors who had jobs with certain physical requirements may need to change jobs or careers following the injury, while other people can perform their prior jobs with just a few adaptations. In either case, what’s most important is that the strengths of the survivor are focused on, instead of the weaknesses. Most vocational therapists, working with both the survivor and the employer, will develop a strategy designed to help the person succeed.
In additional to the vocational therapist at the survivor’s rehabilitation center, there is a federally funded vocational rehabilitation program in each state that helps SCI survivors prepare themselves for work and find jobs.
We mentioned before that just a few years ago survivors were often forced to decide between working and losing their benefits, or not working and keeping their benefits. That’s a terrible choice to have to make, especially considering that work can have a profound positive impact on the survivor. Luckily, there are two Social Security programs that allow SCI survivors to re-enter the workplace without worrying about losing their benefits. One of these programs is called the Ticket to Work Program, and the other is called the Plan to Achieve Self Support, or the PASS.
Let’s first talk about how the Ticket to Work Program functions. All those who are eligible for Social Security and Supplemental Security Income receive a “ticket.” This “ticket” allows anyone who wants to work to access employment support services, including vocational rehab services from approved Employment Networks. Employer Networks are basically providers such as employment counselors, vocational rehabilitation centers, employment agencies, independent living facilities, and other organizations who want to help survivors find meaningful, long-term work. The “ticket’ also expands both Medicare and Medicaid coverage to people SCI survivors who decide to work. If benefits end as a result of work, the person can request to have them reinstated. Finally, anyone using a “ticket” isn’t susceptible to constant disability reviews.
The PASS program is another program that allows SCI survivors more choices and opportunity when it comes to work. Normally SSI rules stipulate that SSI benefits are reduced by any income. The PASS program, however, allows the survivor to work and keep benefits. In order to qualify for the PASS program, an employment plan must be submitted and approved. The program allows for a wide variety of options, from working part-time to starting your own business. If you need to buy things to reach your goals and extra income is necessary, your SSI benefits will usually increase.
You can start by contacting your local Social Security office and asking them for form SSA-545-BK. You’ll want to get this form right, so ask your vocational counselor for help, or log on to www.passonline.org for help and tips. Every once in a while Social Security will want to check up on you to ensure you are still striving toward and meeting the goals outlined in your plan.
In addition to these programs, there are a variety of organizations devoted to supporting SCI survivors in their quest for employment. Some of these offer support and training, while others go so far as to provide capital for people with disabilities who want to start their own businesses.